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Can E-Cigarettes Save Lives?

Two weeks ago, I received an email from NJOY, a company that sells electronic cigarettes. Its purpose was to introduce the Daily, a new product that NJOY described as “a superior e-cigarette scientifically developed to deliver quick-and-strong nicotine satisfaction at levels close to an actual cigarette.”

One reason many adult smokers haven’t switched to e-cigarettes is that most e-cigarettes don’t provide the same nicotine kick as a real cigarette. With some 42 million American adults still smoking, and 480,000 of them dying each year as a result, this is tragic. Though nicotine is addictive, it is the tobacco that kills.

An e-cigarette that could truly replicate the experience of smoking would dramatically reduce — not eliminate, but reduce — the dangers of smoking. NJOY claims that the Daily comes closer to that experience than anything on the market. When I spoke to Paul Sturman, NJOY’s chief executive, he emphasized not only the nicotine aspect, but also the Daily’s “feel,” and “the intensity of the hit to the back of the throat.” Sturman added that the company’s target market is adult smokers who have tried, but rejected, e-cigarettes. He thinks it’s a huge market.

As Sturman was describing the Daily, I thought to myself, “The tobacco-control community is going to hate this thing.” Most anti-tobacco advocates view replicating the feel and satisfaction of a cigarette as an effort to “renormalize smoking.” And though some believe that smokers should be encouraged to move to e-cigarettes, most refuse even to acknowledge the health benefits of “vaping” over smoking.

Indeed, thanks to this vociferous opposition, an increasing number of Americans view vaping as no safer than smoking, which is absurd. And e-cigarette manufacturers like NJOY can’t set them straight: The law giving the Food and Drug Administration regulatory authority over tobacco products, which passed in 2009, prohibits e-cigarette companies from making reduced-harm claims unless they jump through some near-impossible hoops. Thus, NJOY has no way to convey to adult smokers the critical message that e-cigarettes could save their lives.

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The undisputed leader of the tobacco-control community is Matt Myers, who helped found and is the president of the Campaign for Tobacco-Free Kids. Unlike many of his anti-tobacco peers, Myers is on the record as saying that if “responsibly marketed and properly regulated, e-cigarettes could benefit the public health.” But, like many others, he also fears that e-cigarettes may hook a new generation of children on nicotine, and could lead them to start smoking. And in truth, those fears get far more prominence in the Campaign for Tobacco-Free Kids’ various statements about e-cigarettes than its cautious support for them under the right circumstances.

One thing that particularly bothers Myers about e-cigarette companies is their advertising, which he believes employs the same tactics Big Tobacco once used to hook youths on cigarettes. But when I noted that NJOY can’t market the Daily as a reduced-risk product, thanks to the 2009 law — and thus had to find less straightforward ways to induce smokers to try the product — Myers told me that I should blame the F.D.A., which, six years in, has yet to impose a single regulation on e-cigarettes. “I think the F.D.A. deserves to be pilloried,” he said.

He may be right about that. On the other hand, it’s hardly news that government agencies take forever to get things done — and meanwhile, nearly half a million smokers continue to die each year. It seems to me that if the tobacco-control community wants to start saving lives by employing the reduced-harm strategy that e-cigarettes offer, it needs to forget about the F.D.A. and take matters into its own hands.

That means engaging with companies like NJOY that profess to be trying to do the right thing. Instead of demonizing them, the tobacco control community needs to find common ground, and come up with a set of standards — for marketing, manufacturing, and keeping e-cigarettes away from kids — that both sides can agree to. If such a deal were put in place, perhaps with state attorneys general to oversee it, anti-tobacco advocates could talk about the reduced harm potential of e-cigarettes with a clear conscience, without the involvement of the federal government. They then could describe the benefits of e-cigarettes for smokers that the companies themselves can’t.

It’s happened before. Two decades ago, seeing a once-in-a-lifetime opportunity to impose real restrictions on Big Tobacco, Myers engaged in negotiations that included the states’ attorneys general — and Steve Parrish, then a Philip Morris executive. It was an act of tremendous courage — Myers was pilloried when his involvement was revealed — but without his willingness to look the enemy straight in the eye, Big Tobacco would never have been brought to heel.

I believe the time has come for Myers to screw up his courage again. It could be the beginning of the end for one of the greatest scourges on earth.